Managing twins @ nearly 7 months

I am feeling much better nowadays as both the twins and I have adjusted to our daily routine. I could not do it without my Mom of course, who had been nothing but my pillar of strength the whole 7 months through. Thank you Mama you are the best!

I had just finished reading my past posts and have realised how melancholic all of them were. I have always been an emo blogger - it is time to let some sunshine pass through this blog, so that the next time when Rizq and Qays are old enough to read, they would feel excited to read up on what their Mama had been up to while they were growing up.

I have never felt exhausted yet contented at the same time but the last 7 months had been nothing but fun. I love being a mom to twins, despite the fact that they still wake me up every other hour or so at night! Especially if we are at my in laws place. Wonder why. Hehe. The thing about twins is, when they share the same bed, they also tend to wake each other up at night. We are still waking up 4 to 6 times at night, sometimes just to change their sleeping positions. They are good babies though, because when they wake up to nurse at night, they will usually go back to sleep after that. They also prefer to sleep on our bed rather than their own, and Rizq loves to sleep under his Papa's armpit! Hehe. Qays on the other hand, can be a little loud monster when it comes to bedtime. He can scream his lungs out - this one is sure a soprano if he ever joins the choir! There are some nights when I really do not know what to do to pacify him. I always tell myself not to give up though, and will try all methods, by book or by experience to help him fall asleep. It does not help that he is teething and starting to do all sorts of things such as turning and sitting up on his own - there you go, managing cranky babies at night is no easy task! Both of the babies also hate pacifiers and we have more or less give up on introducing the different kinds of pacifiers to them.

At nearly 6 months, we started giving Rizq and Qays solids (with their paed's consent due to their prematurity). We intro solids bit by bit starting with organic brown rice cereals (because I am one paranoid parent and I believe they should start eating organic food 1st). Then we slowly intro apple, pear, avocado, carrot and just recently, sweet potato.. they hated the sour taste of apples and pears so we had to make sure the apples and pears bought were the extra sweet ones. Both threw up a couple of times when the apple and pear they ate were a bit sour. They do not mind the bitter taste of avocados though. The twins are indeed high maintenance babies! The cost of avocados are 3 for S$5! Expensive right?

This is quite a long post and I still have so much to say hence will continue again soon! Till then!

Managing twins - the ups & downs

The twins are back home safe and sound and at nearly 1 month old, have started developing their own traits and personalities. Looking at them sleeping so soundly in between their 3 hourly feeding routines can really melt your heart, and there are times when i will just break down and cry happy tears when i look at them sleeping peacefully.
However, as compared to sigletons, having twins has its major ups and downs - especially since my twin boys are born prematurely. First major downside of having twins who had spent almost 3 weeks at the NICU: Breastfeeding. They are so used to bottle feeding EBM that they are usually confused when I offered them the breasts. Breastfeeding is no easy task, and although i very much want to breastfeed both my boys, i don't have the time or strength to breastfeed both exclusively. I tried tandem once, and although both boys were able to latch, i cannot do it alone. Plus they will only latch a while before giving up and cry in frustration as they did not get enough milk. Every day when i think about the bonding and the benefits that they will receive if i had breastfed them since day 1, i will break down and cry some more. Thus, i had to resort to supplementing my EBM with formula milk. :'(

EBM supply was not a problem 2 weeks ago when i religiously expressed every 3 hourly according to they boys' NICU feeding routine. But since they got home, i had no time to express with all the running around the house taking care of the boys. Diaper change, feeding time and even bath time takes twice as long with twins. There were times when both my mother and i would be so overwhelmed with housework and taking care of the boys, that we love it when there was another family member around to help with the chores. An extra helping hand is definitely appreciated.

33 weeks and beyond!

It has been quite a while since I last updated the page. Be warned though, this is going to be a long post! At 33 weeks, I was starting to get tired easily and would spent most of my time either resting on bed or tidying up the babies' stuff. Did not realize that we actually bought so many clothes for the babies!

The twins have more clothes than me and Hambril combined - all kinds of rompers, kimonos and tshirts, long pants and shorts!

I also signed up to take part in the Johnson's Baby Discovery Project. Received an email from the marketing team to create an interview video but before I could finalize the video, on 22 July 2013, something major that changed our lives forever happened unexpectedly. I was really looking forward to being a participant though, what more with the twins and all, the tasks at hand would be twice as exciting. The incentive offered by the Johnson's Baby team appealed to us as well - 1 year supply of Johnson's Baby products and a sponsored 1st birthday for the twins, awesome right?

Do add Ministry of Moms on Facebook via this link if you would like to participate in quizzes or sending in entries to win awesome Johnson's Baby's products! https://www.facebook.com/MinistryOfMomsByJohnsons

Just by participating in the Discovery Product although we did not make it as a finalist, we received this from the Johnson's Baby team:

Thank you Johnson's Baby!

So.. on 22 July 2013, at nearly 34 weeks pregnant, I was eating Sahur at 5 30am when my mother in law and I were discussing about labor. After Sahur, I was in the toilet taking my wudhu' for Fajr when I heard a "pop" sound and a gush of water trickled down my thighs. I thought it was my bladder but somehow, I knew that this was not normal, that my water bag just broke and I was probably in labor. I told Hambril and while he was in denial that I was actually in labor (he assured me that I had just probably peed in my pants), more water flowed down continuously, this time round I was extremely sure that my water bag just broke and my twins are coming! I showered while Hambril scrambled through my stuff at my in laws to bring to the hospital (my hospital bag was at my parents' place), and we finally made our way to the hospital at around 06 30am that Monday morning. It was day 14 of Ramadhan, and it was a peaceful morning as we made our way to NUH's Delivery Suite.

0700 hrs: Reached delivery suite, still soaking wet as more water flowed. The flow was endless! Everything was in a frenzy as Hambril wheeled me to Room 5.

0800hrs: Changed to hospital gown - no contractions yet so was informed by the nurses that I have to wait for a high risk doctor to come in and assess me. ECG plugs on my stomach to monitor contractions and twins' heartbeats. 1st steroid jab for the twins' lungs to mature was given.

0930hrs: Dr Claudia, one of my high-risk doctor came to monitor the situation and locate the twins' heartbeats as they were still moving around a lot inside my stomach. I was only 2cm dilated - hence not ready for labor yet. Can feel contractions coming on every 10 to 20 mins interval. Like period cramps, it will come and go.

1300hrs: I can't remember who but some doctor or nurse came in to check on the dilation of my cervix. They kept on poking me below, it was so uncomfortable. Contractions starting to get more intense. Still only around 2 to 3 cm dilated. They gave me pills to control the contractions but it did not work. They injected something into my drip but it was useless as well.

1520hrs: Nurse Kelly came in and I told her that I need the epidural because I cannot control the pain. My voice was shaking when I last spoke to my mom on the phone. Period cramp-like pain becoming like I-got-punched-in-the-stomach kind of pain. Level of pain from 1 to 10: 7!!

1645hrs: Got my epidural. It was such an experience as I sat in a shrimp-like position and the doctor injected the wire into my spinal cord. An electric current like sensation was felt and then everything from stomach all the way to the legs went numbed.

1920hrs: Hambril went to break his fast while I was still fasting - I was only given plain water to drink, I was lucky I had sahur in the morning. Was extremely hungry and tired from all the waiting. Dr Sakinah, the Dr who will be delivering my babies came in and told the nurse to give me some biscuits and milo. Yey, at last, some food!

1945hrs: Dr Sakinah came in again and informed me that she had a discussion with Prof B, and concluded that at around 9pm, they will have to do a c-sec on me because the babies might be in distress after being in labor for almost 12 hours.

2000hrs: 2nd steroid jab administered. I hate injections. Dr Sakinah came in again, this time round she said that there is another pair of twins who will be delivered via c-sec soon, hence she is going to let nature takes its course for my twins. No more medicinal interventions until the twins are ready to come out. She assured me that if the twins are going to come out in the middle of the night, both her team and the pediatric team will be on stand-by. The target though, was 0800hrs the next morning. Mode of birth: assisted vaginal delivery

0000hrs: 23 July 2013 - I was sleeping soundly when Nurse Lee Peng came in and told me that she could not locate the 1st baby's heartbeat. After much probing, she checked down below and saw that the 1st twin's head was already near my cervix. I am nearly 10cm dilated and I did not feel anything!

0108hrs: Nurse Lee Peng got me ready for delivery, with Hambril by my side. He was sleeping soundly too so imagine the shock when the nurse came in and suddenly said that I was finally going to have to push the twins out! I was at this point of time, too tired to react panicky, though my heartbeat shot to 137 - which is quite normal for me because I get heart palpitations when I am nervous or anxious. Dr Sakinah came in and told the nurse to decrease the epidural intake. I was starting to feel contractions again and every time I feel like one is coming, I was forced to take a deep breath and push the 1st twin out. It goes on every 5 to 10 mins.

0213hrs: After much pushing (Hambril said I made natural labor seemed over-rated because I was not screaming or kicking around like he imagined I would), Baby R, my 1st born, was delivered naturally. Baby R did not cry when he got out because there was phlegm stuck in his airways. Thank God the pediatricians acted fast, and in no time, they were able to get the phlegm out and Baby R finally cried his 1st cry. I have always wanted to name my 1st born Rizq Nawfal. He was our Rizq (our sustenance, our provisions). Welcome to the world my baby.

0220hrs: The next 7 mins after Rizq entered the world, I started having more intense pain. Baby Q's head is already at the canal, he cannot wait to explore the world as well. I had to start pushing, though the doctors in the suite had ask me to wait while they attended to Rizq 1st. 7 mins later, Baby Q came out crying. Baby Q was named Qays Naushad because we knew from the time they were still swimming around in the womb, Qays has always been the fine, firm and happy baby. Welcome to the world Qays!

Rizq Nawfal weighing 1.6kg at time of birth

Qays Naushad weighing 1.9kg at time of birth

Both babies are still in the NICU at the current moment, growing steadily. InsyaAllah, with God's will, they will grow up to be healthy, happy babies. I cannot wait to bring them home and cuddle them as much as I want.

Rizq - 1 week old

Qays - 1 week old

32 weeks: Caesarean or Vaginal Birth?

Alhamdulillah, the babies have reached 32 weeks - 4 more weeks to go before we welcome them into this world.

Yesterday's AFI and Doppler scans showed that both babies are doing great, Baby R's umbilical blood flow seemed to be more active than Baby Q. Their liquor volume is 5cm for Baby Q and 4.7cm for Baby R. Almost equal, which is a good sign. I have also gained a little bit of weight though my feet have started to swell again. Unlike the same swelling felt a couple a months back though - this is the good kind of swelling where I can still walk around without looking like a penguin.

I had a talk with Dr Anita yesterday on my birthing options. To go for caesarean section or vaginal birth?

Dr Anita is ok with either ways though she did mention that the wound will take longer to heal if I were to deliver via c section. On the other hand, if both the twins' heads are downwards (cephalic presentation), I can opt for a vaginal birth. The only problem with vaginal birth is, the 2nd baby might come out in a breech position if he has more room to move after the 1st baby has been delivered. 

There are many pros and cons between the two - I am still contemplating on whether to go for a c section or vaginal birth - however, most importantly, I do not want to risk my babies' well being, especially since they have been through quite a lot these past few months. Either way, it would still be painful. Oh well.

So I have to do my own research and I came across a couple of videos shown on the baby center website which I found useful. Do check them out via this link: http://www.babycenter.com/0_giving-birth-to-multiples_3585.bc

I also found this website useful http://theasianparent.com/ if you need any information on labour or pregnancy and parenting in general.

We have made it to 31 weeks!

Yey! We have made it passed 31 weeks! Both me and the twins are doing great. I suddenly have this bout of energy inside me to clean, cook and shop! I keep having to remind myself that I have to take it easy and rest sometimes. Hehe.

Yesterday was our appointment at NUH with Prof B and Dr Anita. Finally, a growth scan to see how the babies are doing. Baby Q now weighs 1.6kg and Baby R weighs nearly 1.2kg. Both Prof and Dr said they would want to keep the baby inside for as long as they are growing steadily. I would really be happy if they can stay till 36 weeks where they will be considered full term provided both babies' weights passed the 2kg mark. Both babies' AFI and doppler readings are also stable, thank Allah for the little miracles! Baby Q's AFI is 4.5cm and Baby R's AFI is 3.9cm. Baby R's bladder also seemed bigger compared to Baby Q (i.e the recipient twin during TTTS). Both babies have also changed position, making the sonographers at NUH FCC confused, one week it was Fetus 1 on the left, this week Fetus 1 is situated on the right! Haha!  

I have also gained 2kg - I now weigh 73.3kg, my stomach seems to get bigger but it was not the same feeling I felt back in May when the babies were diagnosed with TTTS. I can also feel very obvious squirming and kicking and the occasional bouts of hiccups from both babies. I love it, it is the best feeling ever to be able to experience 2 human beings forming inside you. 

I have also pre-registered myself to deliver at NUH. We had to make a tough decision to downgrade ourselves to a C class ward due to the babies' condition. The babies' NICU stay will be heavily subsidized if I stay in C Class - that is, if they needed to stay in NICU. InsyaAllah, hopefully all will be well and they can come home with me from the hospital. 

Downgrading to C Class will not only help us financially, but it also means I do not have to bear the burden of repaying hospital debts in the months to come after the babies are born. Less financial burden, less stress, more happy moments with the family.

Do refer to the following websites if you need to compare the bill size between a Private Hospital and a Restructured Hospital. As multiples are often preemies, the following link will tell you more on the costs and financing of delivering via the caesarean section. Do note that the costs is estimated for probably 1 baby only, multiple births will increase the costs respectively. You can also refer to the individual hospitals' websites to know more about how they charge the patients for ward charges, medication, caesarean/natural birth, etc. 

Ministry of Health Singapore:

http://www.moh.gov.sg/content/moh_web/home/costs_and_financing/HospitalBillSize/delivery_caesareansection.html#Volume

National University Hospital of Singapore:

http://www.nuhgynae.com.sg/cos/o.x?c=/wbn/pagetree&func=view&rid=1054246

6 more weeks - Our journey so far

When we see Prof B and Dr Anita tomorrow, I will already be 30 weeks pregnant with Baby R and Baby Q. 6 more weeks and I will finally get to see my precious babies, hug and kiss them as much as I want! Cannot wait for them to pop out so that I can finally hold them. I have already started to buy stuff for the babies, their cute little clothes and baby accessories, but we are still deciding on which cot and stroller to buy. Everything is double with twins, but that makes it more fun because you can buy two different things when you cannot decide on one! Hehehe.

Remember I wrote somewhere that there were more ailments cropping up in the weeks ahead after the surgery? My 2nd trimester was a roller-coaster ride because I had to go through quite a bit to get to week 30.

After the surgery, upon returning to Singapore, my legs puffed up so bad that I could not stand or sit still for long. I was mostly lying on my sides or on my back with my legs elevated to keep the water retention at bay. I could not move around too much, the only time I got out of bed was to go to the toilet or eat. I seriously had no appetite though, given that the longer I sit at the dining table, the more puffed up my legs were. I could not go out as much as a walk down the stairs = puffed up, red, swollen legs. I had heart palpitations now and then as well, because I was anxious about the babies' development. You really have to be strong-willed after the surgery, and in time, lucky for me, everything above started to subside after nearly 2 weeks.

But the ailments did not just stop there. After the puffiness on my legs and belly were more or less gone, I was visited by hive like rashes on my legs and body. I want to put up a picture here but it is too disgusting and I do not want to scare people off. You can however look up on PUPPS here http://www.pregnancycorner.com/being-pregnant/complications/pupps.html . Watch out for symptoms like small blisters and itchiness all over your belly and stretch marks will suddenly appear, blistering red. These were not mere rashes but will occur over large areas on your body, hands or feet. I had to endure another 2 weeks or so of torture, my legs and belly were itching but I refrained myself from scratching. I went to a local GP to get a diagnosis, apparently pregnancy rash such as PUPPS is common among women carrying multiples. The GP I consulted gave me a hydrocortisone-like cream, recommended me body wash for sensitive skin and a hydrating moisturizing cream for dry, sensitive skin. I also found out that I might be allergic to my own sweat, so I had to stay cool all the time and not sweat too much. Alhamdulillah, the rashes finally subsided after much care although the hot weather and the current haze situation in Singapore might cause the rashes to pop up again. This time round, if the rashes comes back, I am prepared.

Apart from the above, I still feel backache and restless legs, cramps and Braxton Hicks now and then while I sleep. There are times when I will wake up in the middle of the night because I feel very uncomfortable. My legs feel very sore and restless, or my hands will cramp up. The best thing to do when you are faced with insomnia is to recite prayers especially for you own well-being and the babies, or buy lots of wedge-like pillows to prop up against your back and tummy when you sleep at night. I get my daily advice on how to overcome such ailments from here: http://www.babycenter.com.sg/

There are times when I will read online forums but if I needed a thorough explanation, I would either consult Prof B or just recently, Dr Anita. I also bought a couple of pregnancy books to help me understand things that I am unsure of, such as TTTS, SIUGR or PUPPS, all common ailments that women pregnant with multiples faced.

For sharing purposes, I bought the following books to read during my free time at home:

You can get them from Kinokuniya if you reside in Singapore or Amazon.com.

P.S: Cannot wait to see my babies on screen tomorrow, keep us in your prayers always!

TTTS and SIUGR?

So we have met with TTTS, fought the battle and so far, we have survived. On week 26, Prof B mentioned that if the twins' amniotic fluids did not stabilize, I have to go for amnio reduction the week after. We more or less have to live week by week - right now, I am not even sure when my due date will be.

On week 27, both twins had an almost equal amount of fluid in their amniotic sacs, hence, we were told that I need not go through amnio reduction. Thank Allah for that because I do not like to be poked around especially since I just got poked on my stomach and both my hands a few weeks back.

Such an unglam picture of me but I must tell you, the stitches on my stomach was not as painful as the needle and tube that the young doctors in Ipoh had poked on my hand to administer antibiotics into my body. By the 2nd night, they had to change the needle to my right hand because they could not get the antibiotics to flow in - the fluid they injected was stuck or something. That stinging pain every time they injected the antibiotics into the tube was so painful, I still have nightmares about it. When they took out the needle, the vein on my left hand was so bruised it hurt when pressure was applied. The next morning, the same thing happened to my right hand - lucky for me, I was discharged in the afternoon.

So on week 27, after battling TTTS for about a month or so (babies' amniotic sacs remained at 10cm for recipient and approx 2.7cm for donor twin for 2 weeks after surgery, before surgery, it was nearly 13cm for recipient and 0 for donor twin), we were relieved to have found out that our babies were doing great. Both donor and recipient finally had 6cm of fluid in their own sacs. We thought that the ordeal was finally over, but like I said earlier, we had to live week by week because TTTS was not the only thing that we had to be worried about - especially for identical twins with shared placenta.

On week 28, our donor twin had 2.97cm of fluid in his sac, while recipient twin had around 5cm. Both babies had a growth spurt but it seemed like donor twin's (i.e Baby R) lower body was a bit smaller than the other parts of his body. Prof B had reported that the donor twin might have Asymmetrical IUGR (read all about it here: http://kidshealth.org/parent/medical/endocrine/iugr.html ) but he did mention that we should not worry too much about it, even my new obgyn, Dr Anita was not too concerned because the doppler readings on Baby R was still stable. Hopefully, both Baby R and Baby Q are growing healthily inside, InsyaAllah.

Meeting Prof B and Dr Anita again tomorrow. Will update again once we have news on the babies' development.

Belly at nearly 29 weeks gestation - 7 more weeks to go to reach full term! :)